GLP-1 medications continue to dominate conversations in the world of employer-sponsored health benefits, and it’s not hard to see why. These drugs have already reshaped care for millions of people living with type 2 diabetes and obesity, delivering meaningful improvements in weight (including in children), cardiovascular health, and overall quality of life. And their reach is expanding fast.
Beyond their well-established role in diabetes and obesity treatment, GLP-1s are now being researched for a wide range of additional conditions — everything from osteoarthritis and Alzheimer’s disease to diabetic complications — and even addiction. As scientific interest grows, so do the complexities employers face in managing pharmacy benefits, projecting future costs, and determining what coverage makes sense. This, of course, directly affects the employees and their families, including their kids.
Let’s take a quick look at the latest developments in the GLP-1 market and what they could mean for employer health programs in the months and years ahead.
Oral GLP-1s are poised to change the market
One of the most anticipated shifts in the weight-loss drug space is the arrival of oral GLP-1 therapies. Oral semaglutide — built on the same active ingredient used in Ozempic, Wegovy, and Rybelsus — is expected to receive approval soon for obesity treatment and for reducing cardiovascular risk in people with obesity. If authorized, it will become the first oral GLP-1 specifically approved for weight management.
Another contender, Lilly’s orforglipron, is expected to receive approval in 2026. Clinical trials show promising results: patients lost roughly 7.8% to 12.4% of their body weight over 72 weeks, only slightly below the outcomes typically seen with injectables.
Because many people prefer pills over injections, oral GLP-1s may boost both uptake and adherence. That likely means increased utilization and higher claims volume. What about pricing? Despite lower manufacturing costs, oral GLP-1s are unlikely to be much cheaper than injectables, and some may even carry a premium due to convenience and strong clinical outcomes.
Generics and new pricing pressures
Cost relief may finally be on the horizon, albeit slowly. Generic versions of Victoza (for diabetes) are already available, and the first generic alternative to Saxenda (for weight loss) has been approved. More generics for Saxenda are expected by March 2026, which should drive prices down.
However, employers won’t see generic versions of the most in-demand injectables (like Ozempic) until at least 2031. Another form of price pressure is emerging: semaglutide products (Ozempic, Wegovy, Rybelsus) appear on Medicare’s 2027 drug price negotiation list. New “Maximum Fair Prices” will be announced in November, and while manufacturers aren’t required to extend discounts to commercial plans, some ripple effects are possible.
What does it mean? Generics won’t dramatically reduce GLP-1 spending in the short term. Medicare negotiations may influence commercial pricing, but the extent is impossible to predict. And employers that currently exclude weight-loss drugs might consider a future “generic-only” benefit once Saxenda generics are plentiful and affordable.
Direct-to-consumer (DTC) models are shaking up pricing
The GLP-1 boom has sparked a wave of direct-to-consumer (DTC) offerings that drastically undercut typical retail prices. Lilly Direct (for Zepbound) and NovoCare (for Wegovy) give patients simplified access and steeply discounted rates. Novo Nordisk even partnered with Costco (yes, Costco) to offer Wegovy at its DTC price through Costco pharmacies. Employers that exclude weight-loss GLP-1s are exploring how to guide employees toward low-cost DTC options without adding these drugs to the plan.
Is this the next “Wonder Drug” class?
GLP-1 therapies continue to earn FDA approvals for conditions beyond diabetes and weight management. Recent developments include Wegovy being approved to treat metabolic-associated steatohepatitis (MASH), and Zepbound being approved for obstructive sleep apnea in people with obesity.
Meanwhile, ongoing trials are evaluating potential use in osteoarthritis, diabetic complications, Alzheimer’s, and addiction — studies that could dramatically widen the patient population in future years.
What does this mean for employer plans?
Employers that already cover GLP-1s for weight loss likely won’t see a large increase in utilization, since the affected populations overlap significantly. Employers that don’t cover weight-loss GLP-1s must make strategic decisions about new indications and potential cost implications, as rebates are typically unavailable unless all FDA-approved indications are covered.
It’s also worth noting that cost-benefit profiles vary widely by condition. In some areas, like MASH, GLP-1s may be cheaper than alternative treatments. In others, such as sleep apnea, they may cost more than existing non-drug therapies.
The weight-loss drug pipeline is exploding
GLP-1s may be leading the market now, but they’re far from the only players. More than 170 weight-loss drug candidates are moving through development pipelines across 82 manufacturers. Many follow GLP-1 pathways, but others target entirely different biological mechanisms, some of which may reduce common side effects like nausea.
One standout is Amgen’s MariTide, a monthly injectable that has shown an impressive 20% average weight loss in one year of clinical trials. Its monthly dosing may appeal to patients looking for convenience over weekly injections.
GLP-1 therapies and the broader weight-loss drug category are moving faster than almost any other segment of pharmacy benefits. For employers, that means the long-term strategy must remain flexible and data-driven as employees may increasingly request coverage for themselves and whoever else is included in their health plan.
Your responses and feedback are welcome!
Source: “Top Five Developments in GLP-1s, Weight-Loss Drugs,” CBIA.com, 11/12/25
Source: “Ozempic at Costco? Discount Giant Expands Into $100 Billion Weight-Loss Drug Market,” Yahoo.com, 10/19/25
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